糖尿病前期尿白蛋白排泄率和微量白蛋白尿患病率的比较

目的　比较糖耐量正常 (NGT)、单纯空腹血糖受损 (I IFG)、单纯糖耐量低减 (I IGT)、糖耐量低减合并空腹血糖受损 (IGT/IFG)、新诊断的 2型糖尿病 (2型DM ) 5种不同糖代谢状态的尿白蛋白排泄率 (UAE)和微量白蛋白尿 (MAU )患病率。方法　根据 75g口服葡萄糖耐量试验 (75gOGTT)结果 ,将 2 93 4例受试者分为 :NGT组 13 3 2例、I IFG组 186例、I IGT组 470例、IGT/IFG组 2 3 6例、新诊断的 2型DM组 710例。用放射免疫法测定过夜 12h尿白蛋白。UAE在 2 0～ 2 0 0μg/min之间定义为MAU。 结果　 (1)UAE水平 [中位数 (四分位数 ) ] ,在新诊断的 2型DM组为8 50 (4 89～ 15 95) μg/min、IGT/IFG组为 6 93 (4 85～ 10 89) μg/min、I IGT组为 6 51(4 0 9～10 74) μg/min ,均高于I IFG组的 5 56(3 70～ 9 2 3 ) μg/min(P值均 <0 0 1) ;I IFG组与NGT组的 5 2 6(3 50～ 8 12 ) μg/min比较差异无显著性 (P >0 0 5) ;MAU的患病率在新诊断的 2型DM组为 2 0 7%、IGT/IFG组为 13 1%、I IGT组为 11 7%、I IFG组为 5 8%、NGT组为 5 6% ,同样呈现上述变化规律。(2 )多元逐步回归分析显示 :UAE与OGTT 2h血糖、舒张压、体重指数呈现独立正相关。logistic回归分析显示 ,导致MAU危险性增加的因素有OGTT 2h血糖、舒张

A study comparing the prevalence of urinary albumin excretion and microalbuminuria in pre-diabetes subjects

OBJECTIVE: To investigate the difference in risks for vascular diseases by comparing urinary albumin excretion (UAE) and prevalence of microalbuminuria (MAU) in subjects with various types of glucose tolerance including normal glucose tolerance (NGT), isolated impaired fasting glucose (I-IFG), isolated impaired glucose tolerance (I-IGT), impaired glucose tolerance combined with impaired fasting glucose (IGT/IFG) and newly diagnosed type 2 diabetes mellitus (T2 DM). METHODS: A total of 2934 subjects recruited in the study were divided into 5 groups based on 75 g oral glucose tolerance test (OGTT) results, NGT 1332 cases, I-IFG 186, I-IGT 470, IGT/IFG 236 and newly diagnosed T2 DM 710 cases respectively. UAE was detected with radioimmunoassay. MAU was defined if UAE was between 20 - 200 micro g/min. RESULTS: (1) UAE [median (25%, 75%)] in the newly diagnosed T2 DM [8.50 (4.89 - 15.95) micro g/min], IGT/IFG group [6.93 (4.85 - 10.89) micro g/min], and I-IGT group [6.51 (4.09 - 10.74) micro g/min] was all higher than that in I-IFG group [5.56 (3.70 - 9.23) micro g/min, P < 0.01, respectively)], but UAE was comparable between I-IFG group and NGT group [5.26 (3.50 - 8.12) micro g/min], P > 0.05. The prevalence of MAU was 20.7% in newly diagnosed T2 DM group, 13.1% in IGT/IFG group, 11.1% in I-IGT group, 5.8% in I-IFG group and 5.6% in NGT group, showing the same trend as UAE in various types of glucose tolerance. (2) Multiple linear regression analysis showed that UAE was positively correlated with OGTT 2h blood glucose (BG), diastolic blood pressure (DBP) and body mass index (BMI). Logistic regression analysis showed that the risk factors for MAU were elevation of BMI, DBP and OGTT 2 h BG, while high-density lipoprotein cholesterol was a protective factor. CONCLUSIONS: UAE and the prevalence of MAU were higher in I-IGT subjects than that in NGT subjects, and much higher in IGT/IFG and newly diagnosed T 2 DM subjects, but there were no significant difference of UAE between I-IFG and NGT subjects. It is suggested that in early stage of abnormal glucose tolerance, postprandial hyperglycemia might be a more important risk factor for UAE and prevalence of MAU than isolated fasting hyperglycemia.